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Circulating Neutrophils Exhibit an Altered Immune Response in Chronic LUTS: An Image-Based Deep Learning Analysis.

Catherine C Y Chieng1, Alia Khoru Azamira1,2, Natasha S Y Liou1,3

  • 1Centre for Kidney and Bladder Health, University College London, London, UK.

International Urogynecology Journal
|April 18, 2026
PubMed
Summary
This summary is machine-generated.

Neutrophils from chronic lower urinary tract symptoms (LUTS) patients show altered responses to bacteria, potentially hindering infection clearance and leading to persistent symptoms. This suggests a dysregulated immune cell function in chronic LUTS.

Keywords:
CommensalsDeep learningImmune responseLower urinary tract symptomsNeutrophilUrinary tract infection

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Area of Science:

  • Urology
  • Immunology
  • Microbiology

Background:

  • Chronic lower urinary tract symptoms (LUTS) are persistent and linked to elevated urinary leukocytes, suggesting an underlying infection.
  • Current diagnostic tests struggle to identify refractory infections, leading to the hypothesis of aberrant neutrophil function in chronic LUTS.

Purpose of the Study:

  • To investigate the hypothesis that neutrophils from chronic LUTS patients exhibit an aberrant response preventing complete disease resolution.
  • To compare the function of neutrophils from healthy individuals and chronic LUTS patients when exposed to bacteria in different urine conditions.

Main Methods:

  • Isolated neutrophils from healthy women and chronic LUTS patients.
  • Stimulated neutrophils with commensal and pathogenic E. coli in artificial, control, or patient urine.
  • Utilized live imaging for 15 hours to analyze neutrophil viability, morphology, activity, and bacterial growth.

Main Results:

  • Neutrophils distinguished between commensal and pathogenic E. coli, with faster death upon pathogenic strain exposure.
  • Patient neutrophils exhibited higher activity and delayed death when stimulated with bacteria in control urine.
  • Patient neutrophils showed reduced survival in patient urine, even without bacterial stimulation.

Conclusions:

  • Neutrophil responses to bacteria are temporally different in chronic LUTS patients.
  • Dysregulation in neutrophil maturation or activation may contribute to symptom persistence in chronic LUTS.
  • Aberrant neutrophil function impairs bacterial clearance and prolongs symptom duration in chronic LUTS.